DEBT RECOVERY APPLICATION FORM

Your Details

Company name

Company Type
(i.e. limited, partnership, charity)

Title *

First name *

Last name *

Position within company
(if applicable)

Address line 1 *

Address line 2 *

Town/city *

County *

Postcode *

Telephone *
(including area code)

Fax
(including area code)

Debtors Details

Company name

Company Type
(i.e. limited, partnership, charity)

Title *

First name *

Last name *

Position within company
(if applicable)

Address line 1 *

Address line 2 *

Town/city *

County *

Postcode *

Telephone *
(including area code)

Fax
(including area code)

Any other relevant information relating to the debtor

The Debt

Total amount outstanding *
(including VAT)?

If the debt is in respect of unpaid invoices, please provide details here

Amount	Invoice No.	Invoice Date	Due Date	Comments
Invoice One Amount	Invoice One Number	Invoice One Date	Invoice One Due Date	Invoice One Comments
Invoice Two Amount	Invoice Two Number	Invoice Two Date	Invoice Two Due Date	Invoice Two Comments
Invoice Three Amount	Invoice Three Number	Invoice Three Date	Invoice Three Due Date	Invoice Three Comments
Invoice Four Amount	Invoice Four Number	Invoice Four Date	Invoice Four Due Date	Invoice Four Comments
Invoice Five Amount	Invoice Five Number	Invoice Five Date	Invoice Five Due Date	Invoice Five Comments

Does the contract with the debtor provide for interest? *

Yes No

If so at what rate?

For a debt which is not in respect of unpaid invoices, please provide a brief summary of how it has arisen, including the date on which the debt occurred and the circumstances surrounding it.

Summary

Connect with Michelmores:

Footer with further navigational links

Michelmores LLP is a Limited Liability Partnership, authorised and regulated by the Solicitors Regulation Authority and registered in England and Wales under Partnership No. OC326242. The registered office is Woodwater House, Pynes Hill, Exeter, EX2 5WR. A list of the members (all of whom are solicitors or barristers) is available for inspection at the registered office and at www.michelmores.com.

End of homepage - Return to Page Content Navigation